Pediatric Agitation in the Emergency Department: A Survey of Pediatric Emergency Care Coordinators.

OBJECTIVE: Acute agitation episodes in the emergency department (ED) can be distressing for patients, families, and staff and may lead to injuries. We aim to understand availability of ED resources to care for children with acute agitation, perceived staff confidence with agitation management, barri...

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Publicado en:Academic Pediatrics Vol. 23; no. 5; pp. 988 - 993
Autores principales: Foster, Ashley A., Saidinejad, Mohsen, Duffy, Susan, Hoffmann, Jennifer A., Goodman, Robin, Monuteaux, Michael C., Li, Joyce
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Jul2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2023
      vid: 23
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      pub: Elsevier B.V.
      place: New York, New York
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        10.1016/j.acap.2023.03.005
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        atl: Pediatric Agitation in the Emergency Department: A Survey of Pediatric Emergency Care Coordinators.
      aug:
        au:
          Foster, Ashley A.
          Saidinejad, Mohsen
          Duffy, Susan
          Hoffmann, Jennifer A.
          Goodman, Robin
          Monuteaux, Michael C.
          Li, Joyce
        affil: Department of Emergency Medicine, University of California San Francisco, Calif
      sug:
        subj:
          Emergency Medical Services
          Emergency Service
          Agitation Therapy
          Competency Assessment
          Pediatric Care
          Human
          Male
          Female
          Child
          Surveys
          California
          Child Development Disorders Therapy
          Autism Spectrum Disorder Therapy
          Funding Source
          Massachusetts
          Rhode Island
          Cross Sectional Studies
          Confidence
          Clinical Competence
          Child: 6-12 years
          Male
          Female
      ab: OBJECTIVE: Acute agitation episodes in the emergency department (ED) can be distressing for patients, families, and staff and may lead to injuries. We aim to understand availability of ED resources to care for children with acute agitation, perceived staff confidence with agitation management, barriers to use of de-escalation techniques, and desired resources to enhance care. METHODS: We conducted a survey of pediatric emergency care coordinators (PECCs) in EDs in Massachusetts, Rhode Island, and Los Angeles County, California. RESULTS: PECCs from 63 of 102 (61.8%) EDs responded. PECCs reported that ED staff feel least confident managing agitation due to developmental delay (DD) or autism spectrum disorder (ASD) (52.4%). Few EDs had a separate space to care for children with mental health conditions (22.5%), a standardized agitation scale (9.6%), an agitation management guideline (12.9%), or agitation management training (24.2%). Modification of the environment was not perceived possible for 42% of EDs. Participants reported that a barrier to the use of the de-escalation techniques distraction and verbal de-escalation was perceived lack of effectiveness (22.6% and 22.6%, respectively). Desired resources to manage agitation included guidelines for medications (82.5%) and sample care pathways (57.1%). CONCLUSIONS: ED PECCs report low confidence in managing agitation due to DD or ASD and limited pediatric resources to address acute agitation. Additional pediatric-specific resources and training, especially for children with DD or ASD, are needed to increase clinician confidence in agitation management and to promote high-quality, patient-centered care. Training programs can focus on the early identification of agitation and the effective use of non-invasive de-escalation strategies.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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